Nevin Manimala

Am J Hum Biol. 2025 Nov;37(11):e70165. doi: 10.1002/ajhb.70165.

ABSTRACT

OBJECTIVES: This study aimed to prospectively identify visceral adipose tissue (VAT) accumulation thresholds in a cohort of sex-, age-, and BMI-matched non-Hispanic White and Black adults using a range of commonly employed whole-body and abdominal-specific adiposity measures associated with chronic disease risk.

METHODS: A total of 344 non-Hispanic White (n = 172) and Black adults (n = 172) matched for sex, age, and BMI completed anthropometric and DXA-based body composition assessments. Anthropometric measures included BMI, waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). DXA was used to quantify VAT, subcutaneous adipose tissue (SAT), body fat percentage (BF%) across the whole body, trunk, and android region, and the android-to-gynoid BF% ratio. Segmented linear regression was used to identify significant sex- and race-specific VAT thresholds for each variable-defined as the inflection points where the relationship between VAT and each variable significantly changed.

RESULTS: Significant VAT thresholds were observed for BF%, WHtR, SAT, android BF%, and trunk BF% in both racial groups, with all thresholds higher for Black than White adults. When stratified by sex, all variables showed significant thresholds in White males, while none were observed in Black males. Significant VAT thresholds were identified for BF%, WHR, and SAT in Black females; WHtR in White females; and android-to-gynoid BF% in both groups.

CONCLUSIONS: After matching for key anthropometric influences, distinct sex- and race-specific VAT thresholds exist for Black and White adults, often falling below current clinical guidelines. These findings support the need for population-specific screening tools to improve early detection and prevention of cardiometabolic risks.

PMID:41190377 | DOI:10.1002/ajhb.70165

Int J Occup Med Environ Health. 2025 Nov 4:211258. doi: 10.13075/ijomeh.1896.02618. Online ahead of print.

ABSTRACT

OBJECTIVES: Adolescent e‑cigarette use is a growing public health concern, yet the influence of family context and risk perceptions on usage patterns remains poorly understood.

MATERIAL AND METHODS: This cross-sectional study investigated relationships between family context, risk perceptions, and e‑cigarette use patterns among a nationally representative sample of 4797 Polish adolescents aged 15-18 years who were current e‑cigarette users (defined as use in the past 30 days). Using computer-assisted web interviews, the authors assessed family factors (parental awareness, attitudes, and nicotine use), risk perceptions, and e‑cigarette use behaviors.

RESULTS: Among adolescent e‑cigarette users, 92.6% engaged in poly-nicotine use (i.e., used ≥1 other nicotine product) with only 7.4% reporting exclusive e‑cigarette use. Notably, 46.7% of participants reported extensive multiple product use (concurrent use of ≥5 products). Structural equation modeling demonstrated that family context significantly influenced e‑cigarette use patterns, both directly (β = 0.31, p < 0.001) and indirectly through risk perceptions (β = 0.12). Risk perception emerged as the strongest direct predictor of e‑cigarette use patterns (β = 0.41, p < 0.001). Parental e‑cigarette use was associated with a 70% increase in adolescents’ likelihood of intensive e‑cigarette use (≥10 times daily) (OR = 1.70, 95% CI: 1.39-2.07, p < 0.001). Traditional cigarette initiation (compared to e‑cigarette initiation) was associated with almost twice the likelihood of multiple nicotine product use (OR = 1.89, 95% CI: 1.67-2.13, p < 0.001).

CONCLUSIONS: These findings highlight the significant influence of family context and risk perceptions on adolescent nicotine use behaviors, suggesting that family-based interventions addressing these factors could be effective prevention strategies. Int J Occup Med Environ Health. 2025;38(5).

PMID:41190369 | DOI:10.13075/ijomeh.1896.02618

Int J Occup Med Environ Health. 2025 Nov 4:211458. doi: 10.13075/ijomeh.1896.02650. Online ahead of print.

ABSTRACT

OBJECTIVES: Burnout is a work-related syndrome with growing relevance in occupational health. This study explored the association between job stress factors and burnout in Korean workers at small- and medium-sized enterprises (SMEs).

MATERIAL AND METHODS: A total of 1024 employees from SMEs (50-299 workers) receiving outsourced occupational health services completed a cross-sectional survey. Job stress was measured using the Korean Occupational Stress Scale short form (KOSS), and burnout was assessed with the Korean version Burnout Syndrome Scale (KBOSS), aligned with International Classification of Diseases, 11th Revision (ICD-11) criteria. Burnout was evaluated across 3 dimensions: exhaustion, cynicism, and reduced efficacy. Burnout syndrome was defined as meeting all 3 dimensions. Multiple logistic regression analyses were performed to assess the associations between job stress factors and burnout.

RESULTS: Burnout syndrome was found in 3.3% of participants. Key findings with statistical measures include: 1) burnout syndrome association – high job demand (Q3: OR = 12.62, 95% CI: 2.03-78.41, p < 0.05) and high overall job stress (Q4: OR = 17.56, 95% CI: 1.40-220.76, p < 0.05); 2) exhaustion predictors – high job demand (Q3: OR = 10.71, 95% CI: 3.64-31.48, p < 0.001), inadequate compensation (Q4: OR = 2.06, 95% CI: 1.02-4.16, p < 0.05), and poor workplace culture (Q4: OR = 2.63, 95% CI: 1.11-6.24, p < 0.05); 3) paradoxical findings – low job autonomy associated with reduced exhaustion (Q4: OR = 0.23, 95% CI: 0.11-0.48, p < 0.001).

CONCLUSIONS: Specific job stressors differentially impact burnout dimensions in Korean SMEs: Job demand and overall stress critically predict burnout syndrome, while inadequate compensation and poor workplace culture significantly affect exhaustion. The counterintuitive protective effects of reduced autonomy warrant further investigation. Organizations should prioritize evidence-based workload management and compensation fairness aligned with ICD-11 diagnostic patterns. Int J Occup Med Environ Health. 2025;38(5).

PMID:41190368 | DOI:10.13075/ijomeh.1896.02650

Headache. 2025 Nov 5. doi: 10.1111/head.15093. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the relationship between migraine attack onset in children and adolescents and Chinooks, which are dry and warm westerly winds that generally occur in the winter and bring about abrupt weather changes to the east of the Rocky Mountains in Southern Alberta, Canada.

METHODS: This was a prospective longitudinal clinical cohort study with recruitment from November 2020 to May 2024. Participants were: 8-18 years old, had migraine as per International Classification of Headache Disorders 3rd edition criteria, had 1-15 headache days/month, lived in the geographical location where Chinook winds occur, and had exposure to at least one pre-Chinook or Chinook day during the study period. Chinook days were defined using Nkemdirim’s criteria and Environment Canada data were used to categorize day type as either Chinook, pre-Chinook, or non-Chinook. Weather data were merged with data from daily headache diaries, completed for periods of 8-30 days. The primary outcome was attack onset, defined as a day with a new migraine attack of moderate or severe severity, as per the 4-point scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe). Both univariate and adjusted models were used to determine if there was an association between migraine attack onset and day type (i.e., pre-Chinook, Chinook, or non-Chinook) at the aggregate study sample level. The adjusted models controlled for age and sex, and both models included a random intercept. Subsequently, individual n = 1 models were fitted to explore each individual participant’s personal odds of migraine attack onset on both pre-Chinook and Chinook days versus non-Chinook days. Pre-Chinook/Chinook sensitivity values were calculated for each individual by dividing the model’s regression coefficient by its standard error. Sensitivity values >1.96 suggest a significant association between pre-Chinook/Chinook days and attack onset.

RESULTS: Sixty youth with 1253 days of complete data, of which 144 (12%) were attack onset days, participated in the study. There were 158 Chinook (13%), 124 pre-Chinook (10%), and 971 non-Chinook days (77%). There were 39 female participants (39 of 60; 65%), with a median age of 14 years (quartile [Q] 1 = 12, Q3 = 16), and a median headache frequency of 6.2 days/month (Q1 = 4, Q3 = 11). Neither the univariate nor the adjusted models found any significant association between day type and attack onset at an aggregate level (pre-Chinook adjusted odds ratio [OR], 0.98; 95% confidence interval [CI], 0.54-1.78, p = 0.947; Chinook adjusted OR, 1.15; 95% CI, 0.69-1.91, p = 0.596). No individual participants met the threshold for statistically significant pre-Chinook or Chinook sensitivity.

CONCLUSION: We did not find a relationship between pre-Chinook and Chinook conditions and migraine attack onset. This may be due to the lack of an association between Chinooks and attack onset in youth with migraine, or due to a lack of statistical power in our study. Future studies with greater statistical power should aim to assess for a potential relationship between Chinooks and attack onset, as it could have important treatment implications.

PMID:41190359 | DOI:10.1111/head.15093

Assessment. 2025 Dec;32(8):1226-1234. doi: 10.1177/10731911241304214. Epub 2024 Dec 29.

ABSTRACT

Some recent studies have revived the approach of investigating extreme levels of self-reported depressive symptoms as indicative of gross exaggeration. While scores above 40 on the Beck Depression Inventory-Second Edition (BDI-II) were discussed as indicating exaggerated symptom claims, different cut scores for identifying noncredible responding are now being discussed. A consecutive sample of 242 patients referred for forensic psychological assessment (mean age: 46.0 years, 47.7% women) with full data sets on the BDI-II and the Structured Inventory of Malingered Symptomatology (SIMS) were assessed. Of all patients, 13.2% scored above 40 and BDI-II scores correlated with SIMS total scores at .62. For different SIMS cutoffs (>14, >16, >19, >23) used as criterion standard, optimal cut scores for the BDI-II were computed. When specificity was set at a minimum of 90%, sensitivity estimates were below 50% for all four SIMS levels. Extreme scores on the BDI-II should raise concern about the credibility of self-reported depressive symptom load. Diagnosis as well as severity estimates should not be based primarily on self-report instruments. To avoid significant risks of bias, the development of reliable cut scores for BDI-II elevations should be based on more studies with samples from diverse contexts.

PMID:41190357 | DOI:10.1177/10731911241304214

Int J Surg. 2025 Nov 5. doi: 10.1097/JS9.0000000000003745. Online ahead of print.

ABSTRACT

BACKGROUND: Restrictive cardiomyopathy (RCM) is an uncommon condition with heterogeneous causes. Amyloidosis, a major subtype, presents with diagnostic complexity, economic burden, and prognostic implications. This study aimed to apply machine learning (ML) techniques to improve the diagnosis of amyloidosis among RCM patients and assess the cost-effectiveness of laboratory tests.

METHODS: This study included patients with RCM who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (MRI). Feature selection was performed using least absolute shrinkage and selection operator (LASSO) regression based on variables that showed statistically differences between groups. These selected features were then used to construct eight ML models, which were trained and validated using leave-one-out cross-validation. The best-performing model was evaluated for sample size and interpreted using Shapley additive explanations (SHAP) to enhance model transparency. Laboratory testing costs related to autoimmune, infectious, tumor-related, and amyloidosis evaluations were compared across subgroups.

RESULTS: The Random Forest (RF) model achieved the best performance, with an area under the curve (AUC) of 0.977, an accuracy of 0.908, a sensitivity of 0.869, and a specificity of 0.927. The model also showed a favorable Brier score and a satisfying effect size, indicating good performance in distinguishing amyloidosis from other RCM subtypes. Cost analysis revealed that patients without underlying autoimmune, infectious, or tumor-related etiologies incurred unnecessary expenditures. Multivariate regression identified key imaging features associated with amyloidosis, including left ventricular posterior wall (LVPW) and left ventricular ejection fraction (LVEF) from TTE, and left ventricular short axis (LVSA), LVEF, and interventricular septum (IVS) thickness from cardiac MRI.

CONCLUSION: This study established an interpretable ML model based on the RF algorithm and accurately distinguished amyloidosis among RCM patients. By guiding more targeted use of amyloidosis-specific testing, the model offers a potential cost-saving strategy while improving diagnostic efficiency. These findings support the clinical integration of ML-based tools to streamline decision-making and optimize the allocation of healthcare resources.

PMID:41190351 | DOI:10.1097/JS9.0000000000003745

BMJ Public Health. 2025 Jul 13;2(Suppl 1):e000873. doi: 10.1136/bmjph-2023-000873. eCollection 2024 Jul.

ABSTRACT

INTRODUCTION: Identifying SARS-CoV-2 infection in high-risk populations is critical. We examined SARS-CoV-2 case detection (CD) in ‘TA’ versus ‘screen-and-test’ models of rapid antigen testing integration in maternal neonatal and child health (MNCH), HIV and tuberculosis (TB) clinics in Cameroon (C) and Kenya (K).

METHODS: From May to October 2022, we conducted a cluster-randomised trial with 10 facilities per country randomised to the ‘test-all’ (TA) intervention arm or the standard ‘screen-and-test’ (ST) arm. Individuals aged >2 years attending HIV, TB and MNCH clinics were eligible for SARS-CoV-2 testing. The primary outcome was the SARS-CoV-2 CD, defined as the number of SARS-CoV-2 infections detected per 1 000 attendees in MNCH, HIV and TB clinics. We estimated the intervention arm-specific CDs by combining the facility-specific estimates using a weighted approach.

RESULTS: There were 80 828 attendee visits in the TA model (63 492 C, 17 336 K) and 71 254 in the ST model (56 589 C, 14 665 K). About 17.4% (K) and 29.0% (C) were tested under the TA model. The overall CD was 2.90 (95% CI:1.76 to 4.79) per 1 000 attendee visits in the TA model and 1.20 (95% CI:0.73 to 1.99) in the ST model (RR=2.41, 95% CI:1.18 to 4.91, p=0.018). The TA model had a significantly higher SARS-CoV-2 CD in MNCH clinics (2.91 vs 1.11, p=0.012), while CD estimates in HIV (2.88 vs 1.40, p=0.203) and TB (10.24 vs 4.57, p=0.051) clinics, although higher in TA model compared with ST model, were not statistically different.

CONCLUSIONS: The TA model identified more SARS-CoV-2 cases than the screen-and-test model, even with low testing coverage. The TA model could be considered in future epidemics for early detection of SARS-CoV-2 infection among vulnerable populations, but effective implementation requires additional human resources to manage testing in high volume clinics.

TRIAL REGISTRATION NUMBER: NCT05382130.

PMID:41190341 | PMC:PMC12581021 | DOI:10.1136/bmjph-2023-000873

Ecol Evol. 2025 Nov 2;15(11):e72410. doi: 10.1002/ece3.72410. eCollection 2025 Nov.

ABSTRACT

Hirudo verbana, a medicinal leech species of conservation concern, has long been considered rare and fragmented across its distribution range due to overexploitation and habitat alteration. In this study, we present the first predictive distribution model for H. verbana in Sicily, combining field occurrence data (time: 1980-2024) with environmental variables using an ensemble species distribution modeling (SDM) framework. Unlike its typical occurrence in temperate lowland wetlands of central-eastern Europe, the species in Sicily shows a marked shift toward upper hill and montane zones. Species presence was strongly associated with high NDVI values, reflecting a preference for areas with dense and structurally complex vegetation. In contrast, presence probability declined sharply with increasing terrestrial human footprint (THF), indicating a notable sensitivity to anthropogenic disturbance. Aquatic habitat type also emerged as a key predictor: the species was most likely to occur in lentic environments such as standing water bodies, and least likely in lotic systems or areas lacking aquatic habitats. Notably, most high-suitability areas overlapped with sites in the Natura 2000 network, emphasizing the importance of existing protected areas as refugia for the species. Moreover, some previously undocumented areas of high habitat suitability were identified, providing a spatially basis for refining monitoring strategies and informing conservation planning for this ecologically sensitive freshwater invertebrate.

PMID:41190312 | PMC:PMC12580294 | DOI:10.1002/ece3.72410

JPEN J Parenter Enteral Nutr. 2025 Nov 4. doi: 10.1002/jpen.70030. Online ahead of print.

ABSTRACT

BACKGROUND: Central line-associated bloodstream infection (CLABSI) persists as a clinical concern, contributing to increased morbidity, mortality, and healthcare costs. Prior studies have demonstrated that parenteral nutrition (PN) is associated with a small but statistically significant increase in CLABSI incidence. In this study, we evaluated the association between patients requiring PN via central venous catheter (CVC) and CLABSI, hypothesizing higher risk among patients receiving PN.

METHODS: We performed a retrospective cohort study of 25,502 adult inpatients with a CVC who were admitted to two affiliated hospitals in a large academic health system in New York City. Univariate and multivariate analyses were performed to examine the relationship between PN and CLABSI risk, with additional subgroup analyses focusing on patients in and out of the intensive care unit (ICU).

RESULTS: During the study period, 25,502 admissions were associated with a CVC, and 186 CLABSI cases were documented. When adjusting for confounders, PN was a significant risk factor for patients outside the ICU (odds ratio, 4.3; 95% confidence interval [CI], 2.4-7.9) but was not a significant risk factor for CLABSI in ICU patients. Hospital-wide, PN administration was associated with a higher risk of CLABSI when adjusting for confounders (2.3; 95% CI, 1.3-3.6).

CONCLUSION: PN is associated with an increased risk of CLABSI in ward patients but not in ICU patients, suggesting context-dependent risk. Further work is needed to determine effective strategies for reducing rates of CLABSI among patients receiving PN hospital-wide and to validate these findings in broader patient populations.

PMID:41189041 | DOI:10.1002/jpen.70030

Pneumonia (Nathan). 2025 Nov 5;17(1):31. doi: 10.1186/s41479-025-00178-8.

NO ABSTRACT

PMID:41189018 | DOI:10.1186/s41479-025-00178-8